Pharmacotherapy for the treatment of depression in patients with alzheimer's disease: a treatment-resistant depressive disorder.

Pharmacotherapy for the treatment of depression in patients with alzheimer's disease: a treatment-resistant depressive disorder.
Expert Opin Pharmacother. 2018 May 04;:1-20
Authors: Lozupone M, La Montagna M, D'Urso F, Piccininni C, Sardone R, Dibello V, Giannelli G, Solfrizzi V, Greco A, Daniele A, Quaranta N, Seripa D, Bellomo A, Logroscino G, Panza F
Abstract
INTRODUCTION: Pharmacotherapy for the treatment of depressive disorders in Alzheimer's Disease (AD) represents a clinical challenge. pharmacological options are often attempted after a period of watchful waiting (8-12 weeks). monoaminergic antidepressant drugs have shown only modest or null clinical benefits, maybe because the etiology of depressive symptoms in ad patients is fundamentally different from that of nondemented subjects. Areas covered: The following article looks at the selective serotonin reuptake inhibitor sertraline, which is one of the most frequently studied antidepressant medications in randomized controlled trials (RCTs). It also discusses many other pharmacological approaches that have proven to be inadequate (antipsychotics, acetylcholinesterase inhibitors, anticonvulsants, hormone replacement therapy) and new drug classes (mainly affecting glutamate transmission) that are being studied for treating depression in AD. It also gives discussion to the phase II RCT on the alternative drug S47445 and the potential effect on cognition of the multimodal antidepressant vortioxet...

Related Links:

Some types of dementia are reversible: The National Institutes of Health says that some types of dementia can be stopped or reversed with treatment. Normal pressure hydrocephalus, caused by excess cerebrospinal fluid, can be helped by surgical intervention. Some drugs, vitamin deficiencies, alcohol abuse, depression, and brain tumors can cause dementia-like symptoms. Most of these causes respond to treatment.
View complete sideshow on HealthCentral about all of the different types of dementia - including Alzheimer's:
MedicareFAQ – Medicare Resource Center
Support a caregiver or jump-start discussion in sup...

Late-life depression (LLD) is the most common mental illness in old age, with a diagnosis in 0.04% to 13.4% of elderly individuals (Guerra, Prina, Ferri, Acosta, Gallardo, Huang et al., 2016) and is associated with a high cost of medical expenses and nursing (Donohue and Pincus, 2007). In addition, patients with LLD have a higher risk of developing cognitive deficit than those without depression (Yeh, Tsang, Lin, Kuo, Yen, Chen et al., 2011). Some authors have also proposed that LLD with cognitive deficit is a preclinical stage of Alzheimer's disease (AD) (Heser, Bleckwenn, Wiese, Mamone, Riedel-Heller, Stein et al., 2016).

CONCLUSIONS: The presence of the HTS in a cognitively impaired individual suggests a diagnosis of AD. A higher HTS frequency correlates with higher CSF total tau levels, a smaller GDS score, and worse cognitive measures. In the MCI subgroup, the HTS may suggest a higher risk of progression.
PMID: 30092564 [PubMed - as supplied by publisher]

Authors: Cornaggia CM, Polita M, Viganò B, Peroni F, Perin C, Beghi M
Abstract
The differential diagnosis between cognitive impairment and functional cognitive impairment (depression) is complex and difficult, especially in the early stages of the disease. The aim of our study was to test linguistic analysis as a diagnostic tool to support clinical, and test-based diagnoses for this differential diagnosis. We enrolled 13 patients, requesting a diagnostic consultation in a Alzheimer Evaluation Unit. A provisional diagnosis through a neuropsychological evaluation (interview and neuropsychological tests) was ma...

Something’s just not right: lately you are forgetful, stressed, and tired all of the time. Symptoms can vary from mood swings, to lack of concentration, to feeling chronically tired, and anxious. To top it off, no matter how healthy you try to eat, you still aren’t losing weight. So let’s add frustrated to the list. And you’re finding that all of this is affecting your performance at work, as a parent, and even as a partner/spouse. It’s not your imagination.
Grains are behind it all…
The grains you consume may have numerous damaging effects on your brain and nervous system, not ju...

Conclusions: The presence of the HTS in a cognitively impaired individual suggests a diagnosis of AD. A higher HTS frequency correlates with higher CSF total tau levels, a smaller GDS score, and worse cognitive measures. In the MCI subgroup, the HTS may suggest a higher risk of progression.Dement Geriatr Cogn Disord 2018;46:42 –49

CONCLUSIONS: Depression is common among individuals with dementia, and the type of dementia and diagnostic criteria affect prevalence estimates of DpD. Further studies are required to understand factors that lead to the development of DpD and strategies to prevent and treat DpD.
PMID: 30085437 [PubMed - in process]

Personality changes in AD have been documented in the literature and may constitute a useful early clinical marker of Dementia (e.g., Cipriani, Borin, Del Debbio,&Di Fiorino, 2015; Duberstein et al., 2010; Duchek et al., 2007; Henriques-Calado, Duarte-Silva,&Sousa Ferreira, 2016; Pocnet, Rossier, Antonietti,&von Gunten, 2011, 2013; Wahlin&Byrne, 2011). Within this field, the most robust and validated personality evaluation measure is based on the Five-Factor Model of Personality. The overall common objective is to understand personality changes in Dementia by comparing the pre-morbid and current measurement...

Abstract
Dietary long chain polyunsaturated fatty acids belong to omega (ω)-3, -6 or -9 series. Both experimental and clinical studies demonstrated the beneficial effect of ω -3 fatty acids of fish oil, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) against human ailments including cardiovascular diseases and rheumatoid arthritis. They are metabolized in cyclooxygenase and lipooxygenase pathways and also by cytochrome P450 isozymes. Biological importance of DHA in the development of brain and retina are established as well. Recent studies highlighted the beneficial effect of ω-3 fatty...

I had to put my life on hold when I decided to take responsibility for my mother. After 8 years of care giving, I found great emotional reward in caring for her. However, I met other caregivers that were clearly suffering from the experience.byAlzheimer's Reading RoomAstudy of spouses ofdementia patients at Case Western Reserve University found that:Some caregivers may have feelings of guilt about participating in activities with friends or in the community when their loved ones are no longer able to do soCaregivers report feelings ofsadness and loneliness25 percent of caregivers in the study suffered fromdepressionand, on...